"An apple a day keeps the doctor away"- an old belief revisited
The S. Daniel International Center for Health and Nutrition
Drora Fraser PhD
Content : Missions , Activities, Research , Links, Teaching, Bibliography
As we stand at the door of a new millennium, we find that the hopes and aspirations of the latter half of the 20th century regarding achievable goals in health, such as "Health for all by the year 2000" (WHO, 1978) are moving further away from our grasp. Tuberculosis and malaria continue to plague health while HIV is rampant in large areas of the world. In spite of our aspirations to conquer world malnutrition and inadequate dietary intake by 2000, environmental and man-made disasters still dictate their presence in our midst. At the same time, new epidemics related to nutrition are spreading world wide as obesity rates soar in adults and children (Ogden et al., 2002; Flegal et al., 2002) ; close behind them are the increases in chronic conditions, such as type 2 diabetes. It has been estimated that during 2000 in the USA alone, poor diet and physical inactivity were responsible for 400 000 deaths, 16.6% of all deaths in that year (Mokdad et al., 2004).
Among life style issues, poor diet and lack of physical activities are increasingly accepted as problems that need to be addressed in any program intended to improve public health. They are, therefore, emphasized more than ever in the individual patient's care package. At the same time, the potential of good health, improved cognitive ability and more productive lives can be offered by different methods of diet enhancement to pockets of populations within developed countries, as well as major population sectors in the developing world.
It is not surprising therefore, that nutrition is receiving more public, media and health care providers' attention. This has led to growth of nutrition related research worldwide, Israel too, that had lagged somewhat in the field, has shown a spurt of nutrition related work. It has also resulted in the formal inclusion of nutrition in students' curricula in medical and para-medical school. The mission of the Negev (BGU) was to address the current needs in nutrition research and teaching within the university's framework.
The Mission 
The S. Daniel Abraham International Center for Health and Nutrition is dedicated to improving health in developed and developing populations. The Center's specific goals and objectives are as follows:
1. To bring together a critical mass of scientists, in both public health and basic sciences, who are committed to research, development and training in nutrition and related issues in both developed and lesser developed populations.
2. To facilitate interdisciplinary research on issues related to nutrition in order to decrease mortality and morbidity, particularly in the fields of communicable diseases, malnutrition, atherosclerosis and cancer. This will be achieved by utilizing state-of-the-art approaches for health promotion and disease prevention in areas related to maternal and child health, human growth and development, and environmental control.
3. To improve the ability of populations to reach their full potential for physical and cognitive development by dietary and health promoting interventions aimed at high risk groups, including pregnant women, infants and children.
4. To increase the life expectancy of older adults and improve their quality of life using dietary and health promoting methods.
5. To increase integration of nutrition teaching into the curricula of all schools in the Faculty of Health Sciences at BGU.
6. To train both public health and basic sciences researchers and practitioners for productive and innovative participation in the above mentioned goals.
7. To establish an international network of contacts to enhance collaborations in research and teaching of nutrition related issues with other countries, including our immediate neighbors.
Activities 
There are three major areas in the current activities of the Center, namely: biomedical and public health research; teaching of undergraduate, graduate and postgraduate students; and creating a national and international network for promotion of research in nutrition through organization of and participations in meetings.
The biochemistry research laboratories of the Center
The overall goal of the research performed in the biochemistry research laboratories of the Center is to contribute to the current understanding of the interactions between nutritional factors and biochemical and intracellular processes related to health and disease. Specifically, we have been focusing our research on the phenomena of insulin resistance, a condition in which skeletal muscle and fat cells cease to respond normally to the major metabolic hormone insulin. This condition is highly prevalent in common conditions, including obesity, type 2 diabetes and sepsis, and is believed to be a causative factor in the excessive related morbidity. The scientific approach includes firstly the cellular and molecular characterization of the defects comprising the insulin resistant state in response to dietary and hormonal factors and to certain insulin resistance-provoking drugs. Secondly, assessing the effects of nutrition and specific nutritional factors in cell culture systems, in experimental animal models and in patients.
Our studies have so far revealed the following findings:
· Oxidative stress is a causative factor in insulin resistance in cell cultures (Tirosh et al., 1999; Tirosh et al., 2001; Pessler et al., 2001; Potashnik et al., 2003).
· The insulin resistant state in fat cells (Rudich et al., 1999) and in rodent models of diabetes (Khamaisi et al., 1999) can be prevented by the nutritional antioxidant lipoic acid. Conjugating lipoic acid to the unsaturated fatty acid gamma-linolenate increases its anti-diabetic effect in rats (Rudich & Bashan, 2002).
· Impaired localization of insulin signaling proteins (Tirosh et al., 1999) enhances degradation of insulin receptor protein 1 (Potashnik et al., 2003) and decreases transcription of the adipose and skeletal muscle-specific glucose transporter GLUT4 (Pessler et al., 2001). These are characteristics of and potential contributors to the impaired capacity of fat cells to respond to insulin in response to oxidative stress.
· Decrease in the cellular content of the natural intracellular antioxidant glutathione is not sufficient to explain oxidative stress-induced insulin resistance (Khamaisi et al., 2000).
· Chronic exposure of fat cells to insulin (Rosenstock et al., 2001) or to anti-retroviral agents induces an insulin resistant state and augments the release of fatty acids. These can be partially improved by insulin sensitizing drugs (Rudich et al., 2001; Ben-Romano et al., 2003; Ben-Romano et al., 2004).
Future research will aim at furthering our understanding of the contribution of oxidative stress and of dietary and/or supplemented antioxidant intake to insulin resistance. An integrated approach, including nutritional assessment of patient cohorts, biochemical and endocrine characterization as well as investigating elements in the insulin signal transduction cascade in fat biopsies, is in preparation. The results of this research may provide valuable information on the relationship between nutritional factors, oxidative stress and insulin resistance of the adipose tissue.
Public Health Research 
The research topics currently pursued in the Center are as follows:
· Development of dietary assessment tools for various Israeli populations.
· Determination of dietary intake adequacy of different population groups.
· Examination of dietary and life-style interventions to improve health and reduce health care costs in specific populations, including older adults, diabetic patients and persons at high risk for diabetes and cardiovascular disease.
· Examination of diet-disease interactions.
· Study of factors associated with childhood morbidity and development.
Several areas of research are detailed below:
Nutrition
An appropriate and valid quantitative assessment of dietary intake was achieved by developing a new instrument. A large survey of different ethnic groups in the Negev population was studied using this tool and interrelations between nutrition and morbidity was shown. For example, abandonment of Mediterranean diet is associated with higher risk for cardiovascular diseases (Bilenko et al., 2005c). Interesting observations on Bedouin diet will be published soon. The changes that the Bedouin society is undergoing associated with accelerated urbanization have a profound effect upon their diet (Abu-Saad et al, 2001).
Another study by the same researchers suggested that Bedouin toddlers who are living outside organized settlements suffer from underweight due to malnutrition significantly more than Bedouins in such settlement, and both are weight less than Jewish children. The opposite is true in regard to obesity and a risk for obesity among (Bilenko & Fraser, 2005d). Also was studied the compliance and satisfaction of Jewish and Bedouin mothers with sprinkle food additions to infants. The results show high acceptability and a low rates of adverse events associated with micronutrients supplementation (Bilnko & Fraser, 2005e).
A group of studies revealed specific nutritional deficiencies among certain groups in the population. For example, a study measured retinol concentration in both maternal and cord serum as an indicator of the nutritional state (Gazala et al., 2003).
A different line of research addressed the nutritional risk in the elderly. This included a dietary assessment by a developing a specifically designed Food Frequency Questionnaire for this age group (Shahar et al., 2003b). The study revealed a decreased energy intake compared to the caloric need. Furthermore, this was associated with more morbidity, and could be a factor in their health status, due to deficiencies in calcium, iron, zinc, vitamins C, B1, B6 and folic acid. These deficiencies are associated with increased morbidity and hospitalization rate for a variety of reasons (Shahar et al., 2005). These deficiencies were especially profound in people 75 year old and more.
Development of dietary assessment tools for various Israeli populations
The Center undertook immediately upon its establishment to develop and validate tools for accurate measurement of dietary intake. One of these questionnaires is for short term (24-hour) recall of diet; the second is to determine long term dietary intake (food frequency questionnaires). The initial stage was to assemble a preliminary food composition table of Israeli manufactured foods and ethnic recipes (Shai et al., 2003a, 2004) which would be continuously updated. These lists were prepared for computerized data analysis in order to evaluate dietary intake in terms of constituents, foods, food groups etc, per questionnaire. This allowed us to survey 1200 persons, who have "Westernized" eating habits, using close to 1500 24-hour recall questionnaires (Shai et al., 2005). The food diary, or log, methodology developed at the Center (another short-term intake questionnaire) allowed us to study the effect of intervention on hypercholesterolemia (Henkin et al., 2000; Henkin & Shai, 2003). We then developed a Food Frequency Questionnaire (FFQ) and tested several methodological issues while doing so. The data entry system we developed allows the coders to modify recipe content. For example change the type of oil used in frying eggs, or replace tomato in a vegetable salad by carrots. We tested whether this ability makes a significant difference to the overall dietary assessment [Vardi et al., 2001; presented at The 4th International Food-Data Conference. Bratislava, Slovakia] and found that for energy intake changing recipes did not make a difference but for individual nutrients, the change was significant. We have therefore maintained this ability in our data entry system. Another issue relates to the data base which supports the FFQ. As items are reported in a group e.g. yogurts of all levels of fat content (from 0% to 5% fat) the nutrient constituents of the line representing Yogurts has to be chosen. While most FFQ data bases use the most frequently reported item e.g. Yogurt 3% fat, we decided to use the data representing the intake in the population [Fraser et al., 2001; presented at 17th International Congress on Nutrition. Vienna, Austria]. In addition we took into account changing consumption patterns with age and sex. For example men eat higher fat content yogurts than women, and the portion size of meat consumed by the older population is smaller than that of the younger adults [Fraser et al, 2003; presented at The 5th International Conference on Dietary Assessment Methods, Chiang Rai, Thailand]. These consideration resulted in the development of an FFQ and the data base supporting which reflects the food intake for the population (Shahar et al,. 2003).
A validation study followed [Shai et al., 2003c, Shai et al, 2005] which showed that the new instruments are valid and reliable, and are equivalent to those of many other European countries, including the UK and Germany (Bingham et al., 1997; Kroke et al., 1999).
The next stage was to develop quantitative measures of food intake of individual who share food from "common plates", such as the Negev Bedouins (Fraser et al., 2003b). Over 600 questionnaires are being currently analyzed. We found for example, that a high proportion of this population maintains its ancient eating habits, using pita bread as the utensil (Fraser, 2001b; Abu-Saad et al., 2001; Fraser et al., 2001b). To the best of our knowledge this methodology is the only published method that allows the quantitative assessment of individual intake (Fraser et al., 2003b). The adequacy and quality of the food intake of pregnant Bedouin women is currently being assessed.
In addition to the study of dietary intake of the Negev adult Jewish and Bedouin populations, we have shared our instruments with the Palestinian Nutrition group at Al-Quds University in a joint project (Abdeen et al., 2002; 2003)
Dietary and life-style interventions
Several ongoing funded interventional studies are aiming at promoting health and lowering health care costs in specific populations. These randomized trials attempt to measure the effect of various diets, with and without additional changes in the life style, such as physical activity, on the improvement of health parameters and health care costs in the following population groups:
· Type 2 diabetes patients in the community
· Elderly patients discharged after acute care hospitalizations.
· Persons with syndrome X and high risk profile for diabetes and/or cardiovascular disease.
· Elderly patients hospitalized (or discharged) from a geriatric institution.
Weight loss strategies are being investigated currently in a large scale dietary intervention study in collaboration with Harvard School of Public Health. This randomized controlled study compared the effect of three different dietary regimes on weight loss and weight loss maintenance and on the changes in vascular disease indicators i.e. regression or progression of three dimensional carotid plaques.
Diet-age and diet disease interactions
The elderly population is a growing segment of the population in the modern societies. The elderly is a population at risk for nutritional deterioration associated with adverse health outcomes. The first project focusing on the elderly population in the Negev includes dietary assessment of a random sample of 378 elderly people. The study (Shahar et al., 2003a) showed that the energy intake of the elderly was lower then the recommendations and calculations of their caloric need. We showed that decreased energy intake was associated with higher number of diseases and medication use suggesting that the gap between energy intake and calculated energy needs may be attributed to compromised dietary intake and health status (Shahar et al., 2003b). Additionally, when comparing the dietary intake of the elderly with that of younger populations aged 35-64, the elderly people, consumed lower quantities of most nutrients, including iron, zinc, vitamins C, B1 and B6 and folic acid. Dietary intake of calcium, zinc, and vitamin E were lower than 75% of the RDA for the elderly. Moreover dietary intake of people over 75 years was significantly lower than that of people aged 65-74 for most nutrients.
A randomized clinical trial for different nutritional care patterns involves the determination of the impact of nutritional status on health care use among the elderly. We showed that elderly people at nutritional risk had higher number of nutritional problems and were hospitalized for longer periods than patients in normal nutritional status during the follow-up period. Decreased appetite and decreased mobility were each associated with increased length of hospitalization. This data is soon to be published.
In addition, we examined the effects of nutrition and other environmental factors on the nutritional status of children and their growth. It should be stressed that the self reporting of diet among children is more difficult and less accurate than among adults. Nevertheless, 240 Bedouin infants were followed up from birth to 18 months of age. Our studies indicate that enteric infections, especially parasitic infestations, influence toddlers' growth (Fraser et al., 2000) cause vitamin A sub-clinical deficiency, and stunting, especially among male infants (Coles, 2004).
In a recent international conference held in Beer-Sheva Conference on Child Nutrition in Israel and Palestine - seeking joint initiatives. Beer-Sheva February 6-9, 2005 we presented the following data. Dr. Natalya Bilenko showed that stunting, which is associated with zinc deficiency in the diet, is also linked to higher rates of hospitalizations for infectious diseases . Anemia which was in Negev settlements using an ecological association was correlated with hospitalization rates, despite controlling for socioeconomic class. We also demonstrated low levels of micronutrients (Zn, iron) and high rates of anemia in well 2 year old Bedouin infants, and showed relatively high rates of malnutrition in Bedouin school boys living outside recognized settlements as compared to Jewish children, and Bedouin girls. On the other hand obesity was more prevalent among Jewish girls and Bedouins living in recognized settlements.
Having collected all the data on micronutrient deficiencies, stunting, anemia, hospitalization rates, and the association between them (Levy et al., 2005) we proceeded to carry out a micronutrient home supplementation project based on the use of a daily single dose sachet of Sprinkles. The very encouraging results of the feasibility study were presented at the meeting by Prof. Drora Fraser and a bi-national Palestinian-Israeli study is now being planned.
National and International links 
Since its establishment, the Center has attempted to strengthen links with local, regional and international researchers in the field of nutrition. Several conferences have been held in Israel, and the Center's members have participated in many international conferences, mainly in Europe. Examples of presentations in early conferences include topics on obesity (Berry, 1996); preventive nutrition in childhood (Deckelbaum, 1996); nutrition and risk for diabetes (Weitzman, 1996); cardiovascular disease as a growing health problem in developing countries: the role of nutrition in the epidemiologic transition (Pearson, 1996); and nutrition and cancer (Fraser, 1996). The most recent conference was a joint meeting of Al-Quds Institute of Nutrition, the Freedman School of Nutrition, Tufts University, and the S. Daniel Abraham International Center for Health and Nutrition at BGU, where food security micronutrient deficiencies and behavior change and communication current status in the region, ideas and suggestion for joint programs were discussed.
The Center's members participated and presented also in more recent conferences, such as the 4th International Food Data Conference in Bratislava, Slovakia, 2001; the European Conference on Food and Nutrition for Better Health, Luciano, Italy, 2001; the 17th International Congress of Nutrition, Vienna, Austria, 2001; the 5th International Conference on Dietary Assessment Methods, Chiang-Rai, Thailand, 2003; the 38th Annual joint meeting of the European and the International Diabetes Epidemiology Groups, Tours, France, 2003; and the 10th World Congress on Public Health and the UK Public Health Association in Brighton, England, 2004. Some of the presentations in these conferences are cited above
One of our graduates Dr. Shai has completed a 2 year post-doctoral fellowship at Harvard School of Public Health and has cemented the BGU-Harvard relationship by obtaining a joint grant (see Epidemiology Department ) and publishing several manuscripts (Schulze et al, 2004a, b, 2005, Shai et al, 2004a, c, c, 2005a, b, c)
Teaching 
Undergraduate teaching
Teaching of nutrition has been integrated into the curriculum of the Faculty of Health Sciences at several levels. The first is a two-day course on nutrition for inserted into other courses, such as hypertension, the elderly, gastrointestinal system and more. These "injections" total 12 hours. Another, is a selective course for 6th year students in the framework of the "selectives" integrating basic and public health sciences and clinical work and examined conditions of patients where an integral part of the care included nutritional considerations. This year a new 26-hour course on nutrition was given to students of the School of Pharmacy. In addition, a 18-hour course on international nutrition is given to the 1st and 2nd year students of the School for International Medicine and Health, every other year .
Postgraduate teaching
There are several programs in the Faculty of Health Sciences for graduate students that involve the study of nutrition. The major one is the specialization track in nutritional epidemiology within the MPH program. Other programs, such as Gerontology also include nutrition courses . The courses currently taught are Nutritional Epidemiology; Nutrition in Health and Disease; Epidemiology of Nutrition in the Young; Nutrition in the Elderly, and Issues in the Statistical Analysis of Data from Nutrition Research. Several additional courses, such as Epidemiology of Chronic Diseases, also encompass a considerable number of topics related to nutrition. Additional courses are presently being planned, supported by the EU Network of Excellence (NOE) grant. These will be distance learning courses, open initially to the Network participants and eventually to all. The courses will include self-evaluation and individual feedback.
Summary
In the few years since it was established by a generous donation from S. Daniel Abraham, the Health and Nutrition Center has made an impact on the academic level of nutritional epidemiology in Israel. The development of methods for dietary assessment at the Center opened new horizons for nutritional research all over the country. The center also provides to both the graduate and the undergraduate students of BGU knowledge related to methodology of clinical research and specialized tools required for dietary assessment. At present, we can say that this combination is unique to our Faculty.
The integration of basic science research with public health gives us built-in capabilities to study the effect of nutrition from the cellular, enzymatic and genomic to population levels. It should be noted that one of the fast growing fields of health research relates to genes-nutrients interactions.
The very existence of this academic Center has, undoubtedly, facilitated and assisted not only the legitimization of the study of nutrition in the eyes of both the public and the medical establishment, but also its academic and academic-clinical status. We have demonstrated in this chapter a wide range of scientific activities, interwoven with intervention on the public health level. We are sure that the Center will continue to be the hub for nutrition research and teaching at BGU, and not necessarily only in the Faculty of Health Sciences, for the sake of bringing the subject of food and eating to the forefront of medical attention.
Bibliography 
Abdeen Z, Shai I, Qasrawi R, Shahar DR, Qleibo M, Vardi H, Dkeidek S and Fraser D. (2002): Self-reported diabetes in Palestinians and southern Israeli Jews. Results from population dietary surveys. 37th Annual Meeting of the European Diabetes Epidemiology Group, Oxford
Abdeen Z, Shai I, Qasrawi R, Shahar DR, Qleibo M, Vardi H, Dkeidek S and Fraser D. (2003): Self-reported diabetes in Palestinians and southern Israeli Jews. Results obtained by comparing two population’s dietary surveys. The 5th International Conference on Dietary Assessment Methods, Chiang Rai, Thailand
Abu-Saad K, Weitzman S, Abu-Rbiah Y, Abu-Shareb H and Fraser D. (2001): Rapid life style, diet and health change among urban Bedouin Arabs of southern Israel. Food, Nutrition and Agriculture, 28: 45-54
Ben-Romano R, Rudich A, Tirosh A, Potashnik R, Sasaoka T, Riesenberg K, Schlaeffer F, Bashan N. (2004): Nelfinavir-induced insulin resistance is associated with impaired plasma membrane recruitment of the PI 3-kinase effectors Akt/PKB and PKCz. Diabetologia) 47(6):1107-17
Ben-Romano R, Rudich A, Torok D, Vanounou S, Riesenberg K, Schlaeffer F, Klip A, Bashan N. (2003): Agent and cell-type specificity in the induction of insulin resistance by HIV protease inhibitors. AIDS, 17:23-32
Berry EM. (1996): Why is the treatment of cancer more successful than that of obesity?. Public Health Reviews, 24:147-163
Bilenko N, Fraser D, Vardi H, Shai I and Shahar RD. (2005): Mediterranean Diet and Cardiovascular Diseases in an Israeli Population. Preventive Medicine, 40:299-305
Bilenko N, Shahar DR, Shai I, Weitzman S and Fraser D. (2003a): Prevalence and characteristics of myocardial infarction, diabetes and hypertension in the adult Jewish population: results from the Negev Nutrition Study. Harefuah, 142: 17-21 (Hebrew)
Bingham SA, Gill C, Welch A, Cassidy A, Runswick SA, Oakes S, Lubin R, Thurnham DI, Key TJ, Roe L, Khaw KT and Day NE. (1997): Validation of dietary assessment methods in the UK arm of EPIC using weighed records and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. International Journal of Epidemiology, 26 (Suppl 1):S137-151
Coles CL, Levy A, Gorodischer R, Dagan R, Deckelbaum RJ, Blaner WS and Fraser D. (2004): Subclinical vitamin A deficiency in Israeli-Bedouin toddlers. European Journal of Clinical Nutrition, 58:796-802
Deckelbaum RJ. (1996): Preventive nutrition in childhood: A rationale. Public Health Reviews, 24:105-111
Flegal KM, Carroll MD, Ogden CL and Johnson CL. (2002): Prevalence and trends in obesity among US adults, 1999-2000. Journal of the American Medical Association, 288:1723-1727
Fraser D, Abu-Saad K and Abu-Shareb H. (2001): The relative importance of traditional and “modern” foods for Israeli Negev Bedouins – A population in transition. Nutrition, Metabolism and Cardiovascular Diseases, 4 (Suppl): S66-69
Fraser D, Shahar D, Shai I, Vardi H, Bilenko N. (2000) Negev Nutritional studies: nutritional deficiencies in young and elderly risk populations. Public Health Rev, 28:31-46.
Fraser D. (1996): Nutrition and Cancer: Epidemiological aspects. Public Health Reviews, 24:113-121
Henkin Y and Shai I. (2003): Dietary treatment of hypercholestrolemia: can we predict long-term success? Journal of the American College Nutrition, 22:555-561
Henkin Y, Shai I, Zuk R, Brickner D, Zuilli I, Neumann L and Shany. S (2001): Dietary treatment of hypercholesterolemia: do dietitians do it better? A randomized, controlled trial. American Journal of Medicine, 109:549-555.
Khamaisi M, Kavel O, Rosenstock M, Porat M, Yuli M, Kaiser N, Rudich A. (2000): Effect of inhibition of glutathione synthesis on insulin action: in vivo and in vitro studies using buthionine sulfoximine. Biochemistry, 349:579-586
Khamaisi M, Rudich A, Beeri I, Pessler D, Friger M, Gavrilov V, Tritschler H, Bashan N. (1999): Metabolic effect of a-lipoic acid - g-linolenic acid conjugate in streptozotocin diabetic rats. Antioxid Redox Signal,1:523-535
Kroke A, Klipstein-Grobusch K, Voss S, Moseneder J, Thielecke F, Noack R and Boeing H. (1999): Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-hour dietary recall methods. American Journal of Clinical Nutrition, 70:439-447.
Mokdad AH, Marks JS, Stroup DF and Gerberding JL. (2004): Actual causes of death in the United States, 2000. Jornal of American Medical Association, 291:1238-1245
Ogden CL, Flegal KM, Carroll MD and Johnson CL. (2002): Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of American Medical Association, 288:1728-1732
Pearson TA. (1996): Cardiovascular disease as a growing health problem in developing countries: The role of nutrition in the epidemiologic transition. Public Health Reviews, 24:131-146
Pessler D, Rudich A and Bashan N. (2001): Oxidative stress impairs nuclear proteins binding to the insulin responsive element in the GLUT4 promoter. Diabetologia 44:2156-2164
Potashnik R, Bloch-Damti A, Bashan N and Rudich A. (2003): IRS1 degradation and increased serine phosphorylation cannot predict the degree of metabolic insulin resistance induced by oxidative stress. Diabetologia, 46:639-648
Rosenstock M, Greenberg AS and Rudich A. (2001): Distinct long-term regulation of glycerol and non-esterified fatty acid release by insulin and TNF in 3T3-L1 adipocytes. Diabetologia, 44:55-62
Rudich A and Bashan N. (2002): Cellular redox state and insulin sensitivity: potential role of lipoic acid. in: Zierath JR (Ed.): Muscle Metabolism. Wallberg-Henriksen H. London, New-York: Taylor and Francis, pp.329-348
Rudich A, Tirosh A, Potashnik R, Khamaisi M and Bashan N. (1999): Lipoic acid protects against oxidative stress induced impairment in insulin stimulation of protein kinase B and glucose transport in 3T3-L1 adipocytes. Diabetologia, 42:949-957
Rudich A, Vanounou S, Riesenberg K, Porat M, Tirosh A, Harman-Boehm I, Greenberg AS, Schlaeffer F, Bashan N. 2001: The HIV protease inhibitor nelfinavir induces insulin resistance and increases basal lipolysis in 3T3-L1 adipocytes. Diabetes 50:1425-1431
Schulze MB, Rimm EB, Shai I, Rifai N, Hu FB. (2004a) The relationship between adiponectin and glycemic control, blood lipids, and inflammatory markers in men with type 2 diabetes. Diabetes Care. 27(7):1680-7.
Schulze MB, Shai I, Manson JE, Li T, Rifai N, Jiang R, Hu FB. (2004b) Joint effects of non-HDL cholesterol and glycated hemoglobin in predicting future coronary heart disease events among women with Type 2 diabetes mellitus. Diabetologia. 47:1760-7.
Schulze MB, Shai I, Rimm EB, Li T, Rifai N, Hu FB. (2005) Adiponectin and Future Coronary Heart Disease Events Among Men With Type 2 Diabetes mellitus. Diabetes. 54(2):534-9.
Shahar D, Fraser D, Shai I and Vardi H. (2003a): Development of a Food Frequency Questionnaire (FFQ) for an elderly population based on a population survey. Journal of Nutrition, 133:3625-3629
Shahar D, Shai I, Vardi H, Brener-Azrad A and Fraser D. (2003b): Development of a semi-quantitative Food Frequency Questionnaire (FFQ) to assess dietary intake of multiethnic populations. European Journal of Epidemiology, 18:855-861
Shahar DR, Shai I, Vardi H and Fraser D. (2003c): Dietary intake and eating patterns of elderly people in Israel: Who is at nutritional risk? European Journal of Clinical Nutrition, 57: 18-25.
Shahar DR, Shai I, Vardi H, Fraser D. (2005) Factors Associated with Low Reported Energy Intake in the Elderly. J Health and Aging. In press.
Shahar DR, Shai I, Vardi H, Shahar A, Fraser D. (2005) Diet and Eating Habits in High and Low Socio-economic Groups. Nutrition. 21(5):559-66.
Shai I, Rimm EB, Hankinson SE, Curhan G, Manson JE, Rifai N, Stampfer MJ, Ma J. (2004a) A multivariate assessment of lipid parameters as predictors of coronary heart disease among postmenopausal women – potential implications for clinical guidelines. Circulation. 110(18):2824-30.
Shai I, Rimm EB, Schulze MB, Rifai N, Stampfer MJ, Hu FB. (2004b) Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men. Diabetologia. 47(10):1760-7.
Shai I, Rosner BA., Shahar DR., Vardi H, Azrad AB., Kanfi A, Schwarzfuchs D, Fraser D. (2005) Dietary Evaluation and Attenuation of Relative Risk: Multiple Comparison between Blood and Urinary Biomarkers, Food Frequency, and 24-hour Recall Questionnaires: The DEARR Study. J Nut. 135(3):573-9.
Shai I, Schulze MB, Manson JE, Rexrode KM, Stampfer MJ, Mantzoros C, Hu FB. (2005c) A prospective study of soluble TNF-alpha receptor 2 (sTNF-RII) and risk of coronary heart disease among women with type 2 diabetes. Diabetes Care. [in press]
Shai I, Shahar DR, Vardi H, Fraser D. (2004) Selection of food items for inclusion in a developed Food Frequency Questionnaire. Public Health Nut. 7(6):745-9.
Shai I, Stampfer MJ, Ma J, Manson JE, Hankinson SE, Cannuscio C, Selhub J, Curhan G, Rimm EB. (2004c) Homocysteine as a risk factor for coronary heart diseases among US women and its relation with inflammatory biomarkers, lipids, and dietary factors. Atherosclerosis . 177(2):375-381.
Shai I, Vardi H, Shahar DR, Azrad A and Fraser D. (2003a): Adaptation of international nutrition databases and data entry system tools to a specific population. Public Health and Nutrition, 6, 401-406
Tirosh A, Potashnik R, Bashan N and Rudich A. (1999): Oxidative stress disrupts insulin-induced cellular redistribution of insulin receptor substrate-1 and phosphatidylinositol 3-kinase in 3T3- L1 adipocytes. A putative cellular mechanism for impaired protein kinase B activation and GLUT4 translocation. Journal of Biological Chemistry, 274:10595-10602
Tirosh A, Rudich A, Potashnik R and Bashan N. (2001): Oxidative stress impairs insulin but not platelet-derived growth factor signalling in 3T3-L1 adipocytes. Biochemistry Journal, 355: 757-763
Weitzman S. (1996): Nutrition and Diabetes Risk. Public Health Reviews, 24:123-129